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July 3, 2026Current Heart Failure Reports

From Cardioprotection to Trial Design: Rethinking Cardiac Safety in Oncology

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Why the study?

Can cardiovascular therapies and strategies routinely used in clinical cardiology mitigate cardiovascular toxicity related to cancer treatments?

Population

Patients undergoing contemporary cancer therapies

Design

Review

Key result

Pharmacological and non-pharmacological interventions show signals of benefit on surrogate endpoints but lack consistent reductions in major clinical cardiovascular outcomes in oncology trials.

Authors

AIAntonio IaconelliRSR ScacciavillaniLCLorenzo Cacioli

Discussion

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Overview

Evidence for preventive strategies in cardio-oncology remains fragmented; leaves open optimal cardioprotection and calls for larger standardized RCTs.

Key Points

  • The central aim is to assess the effectiveness of cardioprotective strategies in cancer therapy-related cardiac dysfunction and the monitoring practices within oncology trials.
  • Critical appraisal of randomized controlled trials evaluating pharmacological and non-pharmacological interventions.
  • Examination of cardiovascular event definitions and reporting practices in major oncology trials.
  • Analysis of the integration of emerging AI tools in cardiac monitoring.
  • Modest benefits observed from pharmacological and non-pharmacological interventions on surrogate endpoints.
  • Inconsistent reductions in clinically significant outcomes like overt heart failure and cardiovascular mortality.
  • Heterogeneous definitions and monitoring of cardiovascular events in oncology trials limit external validity.

Structured PICO

Can cardiovascular therapies and strategies routinely used in clinical cardiology mitigate cardiovascular toxicity related to cancer treatments?

P
Population
Patients undergoing contemporary cancer therapies
I
Intervention
Pharmacological (neurohormonal antagonists, angiotensin receptor-neprilysin inhibition, lipid-lowering therapies) and non-pharmacological (exercise-based) interventions
O
Outcome
Prevention of cancer therapy-related cardiac dysfunction

Current evidence highlights the need for standardized cardiovascular safety frameworks and harmonized monitoring strategies in oncology trials to improve cardiotoxicity detection and reporting.

Limitations

  • Heterogeneous cardiovascular event definitions
  • Incomplete safety reporting
  • Systematic exclusion of patients with pre-existing cardiac disease
  • Heterogeneous cardiovascular event definitions in oncology trials

Cite This Study

Iaconelli et al. (2026) conducted a review in Cancer therapy-related cardiac dysfunction. Pharmacological and non-pharmacological interventions (neurohormonal antagonists, statins, exercise) was evaluated. Pharmacological and non-pharmacological interventions show signals of benefit on surrogate endpoints but lack consistent reductions in major clinical cardiovascular outcomes in oncology trials.

synapsesocial.com/papers/6a475a475c29257aa257ae4chttps://doi.org/10.1007/s11897-026-00765-w
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